To enroll as a Medicaid provider you need
to login to the secured provider portal.

If already a registered provider, please login below.

If you are not a registered provider,
please click the "Web Registration" link below to register.

*User ID

*Password

If you are a first time user, by registering you will
be designated as the Primary Account Holder for your organization.
As the designated Primary Account Holder, you can add, delete or
modify user access.

If you are a user supporting an organization associated with
a provider who is registering in order to submit a Medicaid enrollment
application, then as a new Primary Account Holder registratant, you need
only complete the following step:

Establish a User Id, password and security profile

After the enrollment application is approved, you must then complete the
remaining registration steps noted below:

Request secured access for your organization

Successfully complete a one-time verification process of 3 questions

Upon receipt of confirmation email, click link within email

Sign in to the secured portal

If you are not the Primary Account Holder for your
organization, then you should not register. If your organization already
has a Primary Account Holder, please see them for your User Id and
Password to log in.